| NPI | 1093113722 |
|---|---|
| Former Name | COURTNEY LOUISE LIVELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 20779) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN607077) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN407225) | |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2018-02-27 |