| NPI | 1447553938 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD CR001021) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R49835) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2024-08-24 |