NPI | 1659716710 |
---|---|
Former Name | KHARLA KAY ISAAC DIZON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 805684) |
Enumeration Date | 2013-05-02 |
Last Update Date | 2014-10-21 |