NPI | 1073286613 |
---|---|
Former Name | HAILEY HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014645) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 5014645) |
Enumeration Date | 2021-07-29 |
Last Update Date | 2022-05-31 |