| NPI | 1669157988 |
|---|---|
| Former Name | HOLLY RAE MORDOFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: VA 0136000808) |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2025-05-12 |