| NPI | 1487398269 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN716765) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MD R204736) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R204736) | |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2023-03-28 |