NPI | 1053647248 |
---|---|
Former Name | MICHELLE LEIGH DEAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003113A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 2009009290) |
Enumeration Date | 2009-10-23 |
Last Update Date | 2015-01-23 |