| NPI | 1447869698 | 
|---|---|
| Former Name | NICOLE RODRIGUEZ | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 197099)  | 
| Enumeration Date | 2020-07-23 | 
| Last Update Date | 2024-10-30 |