| NPI | 1790063592 |
|---|---|
| Former Name | SANDRA MICHELLE ELDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006888) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1076668) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2018-01-23 |