| NPI | 1922314269 |
|---|---|
| Former Name | ALISA A VAUGHN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 5540) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 20090240) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2018-08-27 |