Individual
KEANU BEN TOHANNIE
Active
Individual
KEANU BEN TOHANNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CERTIFIED MEDICAL AS
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
E8L6X2B3
TX
Other
Enumeration date
12/07/2015
Last updated
01/05/2016
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