NPI | 1548264047 |
---|---|
Former Name | SANDRA JONES DUBOSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN103532) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 129) |
Enumeration Date | 2005-06-13 |
Last Update Date | 2024-03-19 |