NPI | 1386234037 |
---|---|
Former Name | STEPHANIE HOFF PEDERSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2021004837) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KS 53-79907-022) |
208000000X Pediatrics (Licence: MO 2021004837) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-79907-022) | |
Enumeration Date | 2021-01-26 |
Last Update Date | 2022-04-25 |