NPI | 1417218447 |
---|---|
Former Name | MICHELE DAWN ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 16705) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024171344) |
363LF0000X Nurse Practitioner Family (Licence: TN APN16705) | |
Enumeration Date | 2012-06-06 |
Last Update Date | 2024-09-16 |