| NPI | 1265684989 |
|---|---|
| Former Name | VIVIAN LYNN GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F334576) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 334576) |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2021-11-24 |