| NPI | 1780901439 |
|---|---|
| Former Name | ROSANNA MADDOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704219794) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704219794) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2020-12-18 |