Mimi Song Idicula, NP
NPI #1003009580 in Irving, Texas
Provider Information
- NPI Number
- 1003009580
- Entity Type
- Individual
- Name
- Mimi Song Idicula, NP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner
- Credential
- NP
- Enumeration Date
- Aug 20, 2007
- Last Updated
- Jul 13, 2021
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Chiropractor |
| Nurse Practitioner |
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