NPI | 1467920355 |
---|---|
Former Name | STEPHANIE GWYNN SCHANDERA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN230928) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN230928) |
Enumeration Date | 2018-11-08 |
Last Update Date | 2018-12-14 |