NPI | 1780151597 |
---|---|
Former Name | MAVIS DWAMENA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN223668) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN223668) |
Enumeration Date | 2018-10-30 |
Last Update Date | 2023-06-08 |