NPI | 1073049706 |
---|---|
Former Name | WENDY FAIRALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60755101) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1046292) |
Enumeration Date | 2017-05-01 |
Last Update Date | 2021-10-28 |