| NPI | 1003698507 |
|---|---|
| Former Name | MADELIENE ALEXANDRA JACOB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 12058297-4406) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 12058297-3102) |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2025-04-29 |