| 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 |