| NPI | 1467094052 |
|---|---|
| Former Name | NATALIE RYAN WYNN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9503) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 9502) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2022-06-08 |