NPI | 1194480962 |
---|---|
Former Name | TYESHA JACINDA BROOKES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015370) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015370) |
Enumeration Date | 2021-11-05 |
Last Update Date | 2022-10-26 |