NPI | 1386794022 |
---|---|
Former Name | DEBORAH SUE DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704118417) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704118417) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2021-10-01 |