NPI | 1124527668 |
---|---|
Former Name | TABITHA MORGAN LISLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN60826545) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-132844-071) |
Enumeration Date | 2018-02-11 |
Last Update Date | 2018-02-11 |