| NPI | 1811085699 |
|---|---|
| Former Name | JANITA MARIE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 683961) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F334529) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-04-10 |