NPI | 1760662811 |
---|---|
Former Name | GINA MARIE SPARKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 16530) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 614568) |
Enumeration Date | 2007-11-06 |
Last Update Date | 2022-10-24 |