| NPI | 1982266235 |
|---|---|
| Former Name | MACKENZIE BYRNE WEIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011935) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 266638) |
| Enumeration Date | 2019-07-07 |
| Last Update Date | 2019-11-19 |