| NPI | 1245536473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FINA BOWIE Owner 817-909-6874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 692038) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 69208) |
| Enumeration Date | 2011-02-05 |
| Last Update Date | 2015-06-22 |