| NPI | 1376134700 |
|---|---|
| Former Name | TABBATHA ANN PEMBERTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: MO 2012007205) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |