NPI | 1225142722 |
---|---|
Former Name | SANDRA LYNN GRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 616710) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP112706) |
Enumeration Date | 2006-08-19 |
Last Update Date | 2016-07-26 |