| NPI | 1558914051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 10418) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant |
| 367H00000X Anesthesiologist Assistant (Licence: FL AA537) | |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2021-07-08 |