NPI | 1427240951 |
---|---|
Former Name | JESSICA MYRA GAITHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A03423) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9265161) |
Enumeration Date | 2007-08-17 |
Last Update Date | 2010-08-10 |