| NPI | 1689386989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: IL 238000288) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2023-05-15 |