NPI | 1841550829 |
---|---|
Former Name | LISA R BROCKMEIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557118) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1399613) |
Enumeration Date | 2012-05-23 |
Last Update Date | 2013-01-10 |