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 | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS 903959) |
Enumeration Date | 2020-07-27 |
Last Update Date | 2023-03-20 |