| NPI | 1346669025 |
|---|---|
| Former Name | GERDIE JEAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME136348) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 50683) |
| 207Q00000X Family Medicine (Licence: KY R3520) | |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: KY 50683) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 50683) | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2023-12-29 |