| NPI | 1679823546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 61477) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2014-09-11 |