NPI | 1710611603 |
---|---|
Former Name | SHELBY GILES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71012807A) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: IN 28220040A) |
Enumeration Date | 2022-07-15 |
Last Update Date | 2022-10-22 |