NPI | 1689870438 |
---|---|
Former Name | DEENA ILEEN PREVOST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP115834) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 561587) |
Enumeration Date | 2007-06-26 |
Last Update Date | 2024-09-03 |