| NPI | 1679930697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 10720) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: WI 84) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2021-12-08 |