NPI | 1962178020 |
---|---|
Former Name | MICHELLE ANN MOENART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704306392) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704306392) |
Enumeration Date | 2021-08-19 |
Last Update Date | 2025-06-19 |