| NPI | 1063707263 |
|---|---|
| Former Name | CHRISTIN FAVRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704258522) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 244764) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2021-04-02 |