| NPI | 1013900877 |
|---|---|
| Former Name | CAROL M DERGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP3133532) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209004737) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2017-02-27 |