| 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 |