| NPI | 1497075097 |
|---|---|
| Former Name | TOMMORA DENICE TOLLERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP119152) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 697480) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2015-05-14 |