NPI | 1336523406 |
---|---|
Former Name | SHERINE SHANNAE THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9323) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2295498) |
Enumeration Date | 2015-07-17 |
Last Update Date | 2021-04-09 |