| NPI | 1962578211 | 
|---|---|
| Former Name | MEGAN SARAH RANDALL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 0050-01306)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 005001306)  | 
| Enumeration Date | 2006-11-28 | 
| Last Update Date | 2024-02-28 |