NPI | 1518202753 |
---|---|
Former Name | TARRIE ANN DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704144431) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704144431) |
Enumeration Date | 2012-11-28 |
Last Update Date | 2024-08-28 |