NPI | 1710374731 |
---|---|
Former Name | SCHNESE TANEL BODDIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 129062) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN165424) |
Enumeration Date | 2015-04-16 |
Last Update Date | 2023-03-30 |