NPI | 1083178941 |
---|---|
Former Name | MICHELLE KATRICE BROUSSARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: LA RN133855) |
Enumeration Date | 2019-01-24 |
Last Update Date | 2019-01-24 |