NPI | 1609868298 |
---|---|
Former Name | THERESA G. SPENCER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH NP-06471) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN152359 NP) |
Enumeration Date | 2005-08-19 |
Last Update Date | 2008-02-11 |