| NPI | 1811750078 |
|---|---|
| Former Name | SALLY DIANE TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1182184) |
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: TX 638280) |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-12-20 |