| NPI | 1588674717 |
|---|---|
| Former Name | WALLENA M GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00243400) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR08657200) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN502167L) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2012-09-05 |