NPI | 1689044208 |
---|---|
Former Name | SARAH WALLACE MCCLURE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024172979) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: VA 0001263301) |
Enumeration Date | 2015-09-25 |
Last Update Date | 2022-06-06 |