| NPI | 1750895538 |
|---|---|
| Former Name | CHANNING BREANA EGLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WX0106X Registered Nurse Occupational Health (Licence: UT 9031978-3102) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2017-12-01 |