| NPI | 1023460367 |
|---|---|
| Former Name | JENNIFER EMILY ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704196130) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704196130) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2023-11-03 |