| NPI | 1871155119 |
|---|---|
| Former Name | KATHLEEN LYN DETESO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 059649-23) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2020-07-23 |