NPI | 1366912701 |
---|---|
Former Name | ROZLYN GRACE PETERSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 7982) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 138969) |
207L00000X Anesthesiology (Licence: TN APN0000031389) | |
Enumeration Date | 2018-11-28 |
Last Update Date | 2022-05-27 |