NPI | 1548700123 |
---|---|
Former Name | MICHELLE L SANDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011100) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011100) |
Enumeration Date | 2017-03-02 |
Last Update Date | 2022-09-29 |