| NPI | 1205334687 |
|---|---|
| Former Name | MONICA RENEE SOOBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: VA 0136000290) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2021-12-15 |