NPI | 1245230473 |
---|---|
Former Name | AMY D MALLORY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP113271) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 666203) |
Enumeration Date | 2005-07-29 |
Last Update Date | 2015-02-04 |