| NPI | 1225427123 |
|---|---|
| Former Name | DIANA FREDERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9249248) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2020-12-14 |