NPI | 1194314765 |
---|---|
Former Name | SIERRA JADE MCNAMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: WI 242677) |
Enumeration Date | 2021-01-18 |
Last Update Date | 2021-01-18 |