NPI | 1013468644 |
---|---|
Former Name | JODIE PERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP145696) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001149) |
Enumeration Date | 2016-10-19 |
Last Update Date | 2020-10-20 |