| NPI | 1710470968 |
|---|---|
| Former Name | EDEN LOUISE PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1017810) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 912324) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2020-10-24 |