| NPI | 1659161784 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 719668) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 719668) |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-19 |