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 | 2024-08-30 |