| NPI | 1639381189 |
|---|---|
| Former Name | MICHELLE ANN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX M8484) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M8484) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0053925) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NM MD2026-0355) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2026-04-17 |