| NPI | 1821006057 |
|---|---|
| Former Name | THERESIA M GIDCUMB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209005217) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2021-12-08 |