NPI | 1619400322 |
---|---|
Former Name | SERBRINA N. TENNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: FL HB9327) |
Enumeration Date | 2017-04-10 |
Last Update Date | 2017-04-10 |