NPI | 1043858509 |
---|---|
Former Name | KAREN LYNN GAINES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
Enumeration Date | 2019-12-16 |
Last Update Date | 2019-12-16 |