| NPI | 1215989710 |
|---|---|
| Former Name | ELISA GENTRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 798905) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1109251) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-02-22 |