| NPI | 1063200210 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN283228) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: GA RN283228) |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-06-12 |