NPI | 1780335976 |
---|---|
Former Name | MATAYA MIKESELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 152921) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN728466) |
Enumeration Date | 2022-01-10 |
Last Update Date | 2025-02-04 |