NPI | 1508325242 |
---|---|
Former Name | YASHATE KINKIA PENDERGRASS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: SC 107470) |
Enumeration Date | 2019-03-12 |
Last Update Date | 2019-03-12 |