| NPI | 1811449945 |
|---|---|
| Former Name | JACQUELINE WANDERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 672021-1) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2018-02-26 |