| NPI | 1912780487 |
|---|---|
| Former Name | BROOKE BALO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX f10210229) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 872828) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |