NPI | 1992110969 |
---|---|
Former Name | NANCY GILLIAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71005065A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28188713A) |
Enumeration Date | 2014-06-27 |
Last Update Date | 2021-05-25 |