| NPI | 1497961965 |
|---|---|
| Former Name | DESIREE MICHELLE GOODMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: MT NUR-RN-LIC-24075) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MT NUR-RN-LIC-24075) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2025-11-07 |