NPI | 1174011316 |
---|---|
Former Name | DEANNA DENIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704261973) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009611A) |
Enumeration Date | 2018-04-24 |
Last Update Date | 2020-10-23 |