NPI | 1962884551 |
---|---|
Former Name | CONSUELO BAUER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131503) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19315) |
Enumeration Date | 2015-06-19 |
Last Update Date | 2020-07-28 |