NPI | 1710566484 |
---|---|
Former Name | ROXAN JUNA LEE SIMON UMAYAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: HI 79319) |
Enumeration Date | 2021-04-07 |
Last Update Date | 2021-04-07 |