NPI | 1912359654 |
---|---|
Former Name | MEGAN LEE FARRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704281456) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704281456) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2016-12-28 |