| NPI | 1104461946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: CO 15-709) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 15-709) |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2020-01-15 |