NPI | 1689308140 |
---|---|
Former Name | ALYESSA EGON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1100423) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-07-11 |
Last Update Date | 2025-04-14 |