Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP139291 | TX |
NPI | 1003384199 |
---|---|
Provider Name | Anita Momin Sunesara |
First Address | Sugar Land, TX 77479-2169 |
Second Address | Sugar Land, TX 77479-2329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2018 |
Last Update Date | 06/11/2018 |