NPI | 1619425808 |
---|---|
Former Name | MIREILLE JEAN-MARY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9326614) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP9326614) |
Enumeration Date | 2016-09-15 |
Last Update Date | 2024-06-12 |