| NPI | 1932534039 |
|---|---|
| Former Name | KELLY GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 751741) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000021) |
| Enumeration Date | 2013-09-08 |
| Last Update Date | 2020-04-26 |