NPI | 1790784189 |
---|---|
Former Name | JOAN FAMBROUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3007567) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 042255) |
Enumeration Date | 2005-07-18 |
Last Update Date | 2023-11-06 |