| NPI | 1255849592 |
|---|---|
| Former Name | MOLLIE HELEN HAGOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704278716) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704278716) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-22 |