| NPI | 1609340231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-22 |