NPI | 1245639830 |
---|---|
Former Name | RAEANNE SAVAGE TATEM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NC 20227375) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5007103) |
Enumeration Date | 2014-08-19 |
Last Update Date | 2022-07-11 |