NPI | 1629401260 |
---|---|
Former Name | KRISTEN LEIGH FALCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704266015) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209010651) |
Enumeration Date | 2013-08-19 |
Last Update Date | 2022-07-19 |