NPI | 1497128029 |
---|---|
Former Name | GRACE SIMONE LOCKLUND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129359) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 823154) |
Enumeration Date | 2015-11-04 |
Last Update Date | 2023-03-13 |