| NPI | 1104435148 |
|---|---|
| Former Name | JEANNETTE MARIE GOMEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SD CP002640) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 31205) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2025-12-16 |