NPI | 1871122598 |
---|---|
Former Name | PAULA MARINICA GREEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704318469) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704318469) |
Enumeration Date | 2020-04-04 |
Last Update Date | 2025-10-15 |