NPI | 1073983466 |
---|---|
Former Name | MORGAN MONTEZ FIACCATO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704272573) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4704272573) |
Enumeration Date | 2015-09-29 |
Last Update Date | 2022-03-14 |