NPI | 1669880902 |
---|---|
Former Name | LATOYA NICHOLE SANDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704261258) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704261258) |
Enumeration Date | 2014-07-31 |
Last Update Date | 2024-11-18 |