NPI | 1629145776 |
---|---|
Former Name | CATHERINE M PETRICEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 516176) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 516176-1) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2020-06-09 |