NPI | 1669036653 |
---|---|
Former Name | AISHA WALCOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CT 079511) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CT 079511) |
Enumeration Date | 2019-04-25 |
Last Update Date | 2022-01-18 |