NPI | 1790563708 |
---|---|
Former Name | JENNIFER MARTIN/FROISETH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1134803) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 943231) |
363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1134803) | |
Enumeration Date | 2023-09-20 |
Last Update Date | 2023-11-14 |