| NPI | 1417355884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 161310) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 14-572) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2023-06-22 |