| NPI | 1295388510 |
|---|---|
| Former Name | IVY ATHENA RODRIGUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP142275) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP142275) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2023-11-17 |