NPI | 1104264886 |
---|---|
Former Name | CISLYN JACINTA BLAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP123971) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 835762) |
Enumeration Date | 2013-06-04 |
Last Update Date | 2022-07-13 |