NPI | 1467024281 |
---|---|
Former Name | MICHELLE LEIGH LUKOMSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015127) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC LUKO-63AB4) |
Enumeration Date | 2021-07-12 |
Last Update Date | 2022-05-12 |