| NPI | 1013870765 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11044496) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9580622) |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2026-01-23 |