NPI | 1376752832 |
---|---|
Former Name | DALLAS MAXWELL RODGERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R868182) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 12310) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2024-10-17 |