| 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 | 2015-05-04 |