NPI | 1467694414 |
---|---|
Former Name | GENA MARIE ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9168974) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL RN9168974) |
Enumeration Date | 2009-04-06 |
Last Update Date | 2018-06-15 |