| NPI | 1508700733 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 159547) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 357459) |
| Enumeration Date | 2026-04-17 |
| Last Update Date | 2026-06-22 |