| NPI | 1023525011 |
|---|---|
| Former Name | GRACE MIKAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R231057) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R231057) |
| 163W00000X Registered Nurse (Licence: SC 232808) | |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2019-07-30 |