NPI | 1063791036 |
---|---|
Former Name | LISA MARIE TATKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 87184) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 213867) |
Enumeration Date | 2011-08-09 |
Last Update Date | 2023-06-07 |