NPI | 1073693206 |
---|---|
Former Name | SANDRA GASS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN12432) |
Additional Taxonomies | 207N00000X Dermatology (Licence: TN apn12432) |
363L00000X Nurse Practitioner (Licence: GA RN083514) | |
Enumeration Date | 2006-10-16 |
Last Update Date | 2020-08-07 |