| NPI | 1730826801 |
|---|---|
| Former Name | ALYSSA MARIE PORTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704351625) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704351625) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2023-11-01 |