| NPI | 1891442372 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 855354) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001283967) |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2025-02-14 |