| NPI | 1114590510 |
|---|---|
| Former Name | SHANET MATHEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1152696) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: TX 795537) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1152696) | |
| 363LS0200X Nurse Practitioner, School (Licence: TX 795537) | |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2024-05-15 |