NPI | 1326533373 |
---|---|
Former Name | MICHELLE LEI MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA AP61033178) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 022889) |
Enumeration Date | 2018-06-22 |
Last Update Date | 2022-04-08 |