| NPI | 1740665066 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 173829) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 901822) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2023-04-17 |