NPI | 1235400623 |
---|---|
Former Name | SHELBY L RIVES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209020424) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2012001557) |
Enumeration Date | 2012-01-18 |
Last Update Date | 2024-07-15 |