NPI | 1700236593 |
---|---|
Former Name | MARY LAUREN MAGARGEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024174591) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 701859-1) |
163W00000X Registered Nurse (Licence: VA 0001267841) | |
Enumeration Date | 2016-06-13 |
Last Update Date | 2018-01-31 |