NPI | 1245439488 |
---|---|
Former Name | GENELL DEE JACOBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 17632) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 308402) |
Enumeration Date | 2007-07-17 |
Last Update Date | 2016-05-16 |