NPI | 1255811279 |
---|---|
Former Name | KIMBERLY ANN HERNANDEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1058109) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 872655) |
Enumeration Date | 2018-08-20 |
Last Update Date | 2021-11-19 |