| NPI | 1053646299 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN596454) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ RN596454) |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2025-01-30 |