| NPI | 1982401444 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209032833) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: VA 0001278023) |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-12-10 |