NPI | 1467299727 |
---|---|
Former Name | ILENE NICOLE DIAZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1170306) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2024-07-12 |
Last Update Date | 2024-08-01 |