NPI | 1720508971 |
---|---|
Former Name | GWENDOLIN B SHAFFER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22722) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 120275) |
Enumeration Date | 2017-06-20 |
Last Update Date | 2022-07-21 |