NPI | 1326248592 |
---|---|
Former Name | NICHOLE LYNN JUAREZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 803689) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 17282) |
Enumeration Date | 2007-07-24 |
Last Update Date | 2011-11-09 |