NPI | 1861045049 |
---|---|
Former Name | SHAUNA RAENELL HERBER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO RN.1663084) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 756553) |
Enumeration Date | 2019-07-17 |
Last Update Date | 2019-07-17 |