| NPI | 1982985057 |
|---|---|
| Former Name | TINA MARIE PATRICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4179) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP4179) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2021-02-23 |