NPI | 1518134659 |
---|---|
Former Name | BRANDON SHEA ELLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A00727) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 13448) |
Enumeration Date | 2008-05-08 |
Last Update Date | 2019-04-24 |