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Individual

ELLAH GWANYANYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
903 LA FALDA # SA, SAN ANTONIO, TX 78258-2930
(510) 459-2383
Mailing address
903 LA FALDA # SA, SAN ANTONIO, TX 78258-2930
(510) 459-2383

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
898596
TX

Other

Enumeration date
08/17/2018
Last updated
08/17/2018
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