NPI | 1619227667 |
---|---|
Former Name | NICOLE SHUNAMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MA 2311801) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382294) |
Enumeration Date | 2012-09-18 |
Last Update Date | 2022-02-09 |