| NPI | 1487399101 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN610805) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN610805) |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-08-30 |