| NPI | 1649789892 |
|---|---|
| Former Name | HAZEL RAE DALTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP135818) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F09170837) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2022-10-18 |