NPI | 1386750099 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MN 875) |
Enumeration Date | 2006-08-23 |
Last Update Date | 2008-05-01 |