NPI | 1326319013 |
---|---|
Former Name | MICHELLE SANDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19827) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 204496-7) |
Enumeration Date | 2012-01-26 |
Last Update Date | 2016-12-02 |