NPI | 1043672074 |
---|---|
Former Name | MICHELLE NICOLE MOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MS 31956) |
Enumeration Date | 2016-03-29 |
Last Update Date | 2023-08-21 |