| NPI | 1174106702 |
|---|---|
| Former Name | ALYSE MICHELLE TRAILER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014377) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5014377) |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2022-08-24 |