| NPI | 1518643675 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-558146-031) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 875482) |
| 163W00000X Registered Nurse (Licence: KS 14-161414-031) | |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2023-09-20 |