| NPI | 1659510030 |
|---|---|
| Former Name | BRE'ANNE B MALLON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704244156) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168166) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2012-10-12 |