NPI | 1366155061 |
---|---|
Former Name | TABITHA MARIE PFAFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71013426A) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71013426A) |
Enumeration Date | 2022-12-28 |
Last Update Date | 2023-04-06 |