NPI | 1407543556 |
---|---|
Former Name | CASSANDRA PEDIGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 12705653-4405) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-04-19 |
Last Update Date | 2024-11-13 |