| NPI | 1710485669 |
|---|---|
| Former Name | KELLY JOANNE MUNGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: MI 4704191818-RN) |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-01-25 |