NPI | 1750471249 |
---|---|
Former Name | STEPHANIE N WYATT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: TX 117640) |
Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AR A01493) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2024-11-19 |