| NPI | 1407125198 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704259307) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704259307) |
| Enumeration Date | 2011-12-24 |
| Last Update Date | 2017-02-09 |