| NPI | 1255818993 |
|---|---|
| Former Name | KERRYN CASTELLON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: GA LDO002538) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-07-25 |