| NPI | 1043678022 |
|---|---|
| Former Name | MICHAEL SCOTT COOPER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6731) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 6731) |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2020-03-17 |