| NPI | 1902596786 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 215660) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0130182) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2025-01-29 |