| NPI | 1912691403 |
|---|---|
| Former Name | SHONETELLE MARIE BIROTTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 230865) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 130024) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2023-06-15 |