NPI | 1407497027 |
---|---|
Former Name | MICHELLE ERIN WORMSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704321950) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704321950) |
Enumeration Date | 2019-10-04 |
Last Update Date | 2022-03-28 |