| NPI | 1134374374 |
|---|---|
| Former Name | VICTORINE TENGU FOMBO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP135210) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 920605) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2018-02-05 |