Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 971449 | TX |
NPI | 1326709494 |
---|---|
Provider Name | Mrs. Shqiponje Hajdari Young |
First Address | Fort Worth, TX 76104-4805 |
Second Address | Plano, TX 75093-8185 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2021 |
Last Update Date | 31/12/2021 |