| NPI | 1750876785 |
|---|---|
| Former Name | DAVID DWAYNE ROGERS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP138602) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 851509) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2018-08-24 |