| NPI | 1568553576 |
|---|---|
| Former Name | BETHANY MANSTROM (FONTAINE) |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R26471) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2019-02-28 |