NPI | 1104045848 |
---|---|
Former Name | JENNIFER ELSETA THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY f340665-1) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2013-05-16 |