| NPI | 1750763470 |
|---|---|
| Former Name | MICHELE MAE FAUL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6411-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 150581-30) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2020-06-05 |