NPI | 1063082287 |
---|---|
Former Name | ELLEN DEKLEVA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3017235) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2015015857) |
Enumeration Date | 2021-06-29 |
Last Update Date | 2023-08-07 |