| NPI | 1104285113 |
|---|---|
| Former Name | MATTIE FAYE WATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: DE L1-0021469) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-18 |