| NPI | 1720316763 |
|---|---|
| Former Name | COURTNEY BRADDOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704241423) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704241423) |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2021-04-01 |