NPI | 1366164824 |
---|---|
Former Name | CARISSA SUE COON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704310689) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704310689) |
Enumeration Date | 2022-09-13 |
Last Update Date | 2022-09-13 |