| 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 |