| NPI | 1093019747 |
|---|---|
| Former Name | JACLYN M MATESOWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704253212) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2017-02-09 |