| NPI | 1407261084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 147747) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX 147747) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-09-21 |