| NPI | 1568134021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3017201) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 136248) |
| 163W00000X Registered Nurse (Licence: TN 0000210337) | |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2022-03-02 |