| NPI | 1861013930 |
|---|---|
| Former Name | NATALIE RENEE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 60966) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2025-07-29 |