| NPI | 1104828136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 15) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CT 000259) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 452674) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2018-05-22 |