| NPI | 1083177539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL 9640271) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 19-171) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2023-09-12 |