| NPI | 1972136331 |
|---|---|
| Former Name | LATESHA DAWN PAIT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 501294) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 501294) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 194716) | |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2024-06-27 |