| NPI | 1144213620 |
|---|---|
| Former Name | SUSAN MARIE BALDIS MCDONOUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ RN127732) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 1068804) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY ARNP2076A) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 30756) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2007-10-24 |