| NPI | 1366648719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: GA 10-0825) |
| Additional Taxonomies | 174400000X Specialist (Licence: IA 00300) |
| 174400000X Specialist (Licence: MN 1835) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2011-10-31 |