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 |