NPI | 1750704797 |
---|---|
Former Name | AMANDA M ELLIOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209.011212) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.368295) |
Enumeration Date | 2014-01-28 |
Last Update Date | 2015-09-23 |