NPI | 1790842961 |
---|---|
Former Name | KOREEN MONTGOMERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704135085) |
Enumeration Date | 2007-01-03 |
Last Update Date | 2007-07-08 |