| NPI | 1700396298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant (Licence: KS 12-204) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MO 12-0204) |
| 225500000X Specialist/Technologist (Licence: MO LKFKCMO2016PBMT) | |
| 246RP1900X Technician, Pathology, Phlebotomy (Licence: MO 24389-pt05) | |
| 363AM0700X Physician Assistant, Medical (Licence: KS 12-0204) | |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |