NPI | 1679231690 |
---|---|
Former Name | AUDREY MICHELLE DARBONNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209025875) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021048680) |
363LF0000X Nurse Practitioner, Family (Licence: MO 2021048680) | |
Enumeration Date | 2021-12-07 |
Last Update Date | 2024-06-12 |