| NPI | 1790941102 |
|---|---|
| Former Name | CYNTHIA PEACOCK THELEEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301101410) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125050909) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2024-01-15 |