| NPI | 1891763090 |
|---|---|
| Former Name | MICHAELENE P MIRR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 68695-30) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 221-33) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2016-05-23 |