NPI | 1104340009 |
---|---|
Former Name | KRYSTEL GAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP134720) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX AP134720) |
Enumeration Date | 2017-08-01 |
Last Update Date | 2018-01-30 |