| NPI | 1902791783 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP70021166) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60817179) |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-08-12 |