Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP135824 | TX |
NPI | 1003305558 |
---|---|
Provider Name | Mukuka Mukupo Mumbi |
First Address | Richmond, TX 77407-2634 |
Second Address | Houston, TX 77024-2501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2018 |
Last Update Date | 09/05/2018 |