NPI | 1366853541 |
---|---|
Former Name | GINA R ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013044837) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 20113044837) |
Enumeration Date | 2014-05-10 |
Last Update Date | 2023-10-16 |