NPI | 1497001929 |
---|---|
Former Name | SHANA RAE ZAWACKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA 60929733) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 644500-1) |
Enumeration Date | 2012-08-02 |
Last Update Date | 2022-01-20 |