NPI | 1699244830 |
---|---|
Former Name | AMY LORRAINE GOODMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP139666) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139666) |
Enumeration Date | 2018-11-16 |
Last Update Date | 2024-05-06 |