NPI | 1568182251 |
---|---|
Former Name | GABRIELLE RENEE CARTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025868) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 041464080) |
Enumeration Date | 2022-09-01 |
Last Update Date | 2023-11-22 |