NPI | 1659931178 |
---|---|
Former Name | LAUREN WATRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1051407) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN268442) |
Enumeration Date | 2019-06-17 |
Last Update Date | 2022-05-01 |