| NPI | 1588198709 |
|---|---|
| Former Name | MIA MARISSA HERNANDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: TX AP133643) |
| Additional Taxonomies | 364SN0000X Clinical Nurse Specialist, Neonatal (Licence: TX AP133643) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2017-09-20 |