| NPI | 1154901809 |
|---|---|
| Former Name | STEPHANIE ROSE LEANNA-WIJAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 11127-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 223367-30) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2021-08-19 |