| NPI | 1083927701 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R252925) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN111489) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC002835) | |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2024-08-09 |