NPI | 1588379788 |
---|---|
Former Name | SHEREE LACHELLE GHENT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209026727) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209.026727) |
Enumeration Date | 2023-01-23 |
Last Update Date | 2024-11-26 |