| NPI | 1679792931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN055680) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 34544) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2012-09-14 |