| NPI | 1205108792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 22259) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA 166513) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2020-07-16 |