Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | STUDENT | TX |
NPI | 1306510367 |
---|---|
Provider Name | Sadaf Yahyai Rezaee |
First Address | Dallas, TX 75246-2017 |
Second Address | Dallas, TX 75246-2017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2021 |
Last Update Date | 03/08/2021 |