NPI | 1275602633 |
---|---|
Former Name | JANELISE S GUNNING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MT NUR-APRN-LIC-125338) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP661A) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2024-07-07 |