| NPI | 1821688334 |
|---|---|
| Former Name | KASANDRA NICOLE ANTIONETTE PHANARA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0996321-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 000000000) |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-03-01 |