NPI | 1982304630 |
---|---|
Former Name | EMILY G DOUGLASS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 10000858) |
Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: OR 10000858) |
Enumeration Date | 2023-03-09 |
Last Update Date | 2025-02-14 |