NPI | 1255968954 |
---|---|
Former Name | SHANNON ENLOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 64423) |
Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: AL 1-166204) |
Enumeration Date | 2020-03-24 |
Last Update Date | 2020-06-02 |