NPI | 1083855860 |
---|---|
Former Name | DEBRALEE DENISE GORMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 219637) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 171941) |
Enumeration Date | 2009-03-09 |
Last Update Date | 2019-09-10 |