| NPI | 1255004131 |
|---|---|
| Former Name | MADELINE RAE AVERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95198067) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 95198067) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2021-08-16 |