NPI | 1902684012 |
---|---|
Former Name | MEGAN RUTH BRYANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: AL 1-202395) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 905699) |
Enumeration Date | 2023-09-19 |
Last Update Date | 2024-12-20 |