| NPI | 1407196157 |
|---|---|
| Former Name | EMILY ROSE DAGUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX AP131661) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 53-75923-072) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 2013003427) | |
| Enumeration Date | 2013-02-17 |
| Last Update Date | 2018-05-25 |