| NPI | 1396347282 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704263649) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4704263649) |
| Enumeration Date | 2020-11-15 |
| Last Update Date | 2024-10-21 |