| NPI | 1699669218 | 
|---|---|
| Entity Type | Individual | 
| Gender | N/A | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 39040) | 
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 1-174906) | 
| Enumeration Date | 2025-06-06 | 
| Last Update Date | 2025-07-24 |