NPI | 1215360284 |
---|---|
Former Name | VIVIAN MARIE THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP12414 / RN 769952) |
Enumeration Date | 2013-08-14 |
Last Update Date | 2015-04-24 |