NPI | 1932560067 |
---|---|
Former Name | TINA LYNN LOUIE PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60637603) |
Enumeration Date | 2016-03-17 |
Last Update Date | 2016-04-26 |