NPI | 1053745257 |
---|---|
Former Name | RACHAEL DAWN SOVA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704259916) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704259916) |
Enumeration Date | 2013-08-25 |
Last Update Date | 2024-03-12 |