| NPI | 1124308523 |
|---|---|
| Former Name | CARLY MARQUIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NH 073463-23) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 28185426A) |
| 363L00000X Nurse Practitioner (Licence: MI 4704309057) | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2023-05-16 |