NPI | 1013589092 |
---|---|
Former Name | KELLY TOMLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6809) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 300560) |
Enumeration Date | 2021-07-11 |
Last Update Date | 2023-02-09 |