| NPI | 1770140592 |
|---|---|
| Former Name | ELLA MARIE MANGOL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN500853L) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |