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 |