| NPI | 1497150106 |
|---|---|
| Former Name | PAIGE KACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C163934) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 20142314) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2023-06-05 |