| NPI | 1770684730 |
|---|---|
| Former Name | ELLEN GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 556865) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 138678) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2014-08-11 |