NPI | 1811223738 |
---|---|
Former Name | ELAINA SUSAN FUSSY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 764) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1695582) |
367500000X Nurse Anesthetist, Certified Registered (Licence: NC 083446) | |
Enumeration Date | 2009-10-28 |
Last Update Date | 2022-07-21 |