| NPI | 1689388175 |
|---|---|
| Former Name | PAIGE HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022037798) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209026479) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-11-02 |