NPI | 1730612573 |
---|---|
Former Name | TIFANI BRINEGAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA 60615642) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 818761) |
Enumeration Date | 2017-04-08 |
Last Update Date | 2017-04-08 |