| NPI | 1578021374 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 557708) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-120438-042) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2023-08-23 |