| NPI | 1699572057 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704330840) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704330840) |
| Enumeration Date | 2025-02-25 |
| Last Update Date | 2025-06-29 |