NPI | 1780125336 |
---|---|
Other Name | JORDAN TERRY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP133301) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP133301) |
Enumeration Date | 2017-03-15 |
Last Update Date | 2021-03-19 |