| NPI | 1407694417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9659665) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL RN9659665) |
| 363A00000X Physician Assistant (Licence: PR 3058) | |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 22-626) | |
| 363AS0400X Physician Assistant, Surgical (Licence: PR 3058) | |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2026-05-11 |