NPI | 1568414027 |
---|---|
Former Name | AMANDA LYNNE MIETTINEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704269636) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024166853) |
Enumeration Date | 2006-05-16 |
Last Update Date | 2019-12-10 |