| NPI | 1558618629 |
|---|---|
| Former Name | LITISHA MARIE MILLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5036-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 143225-030) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2013-01-16 |