| NPI | 1730789900 |
|---|---|
| Former Name | GINA RENAE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND 201308) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN239823) |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2025-01-07 |