| NPI | 1013603554 |
|---|---|
| Former Name | EMME LANE PRAYDICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001526) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 268977) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2025-08-29 |