| NPI | 1720536873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: MO 2017021102) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: WI 86-017) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2019-09-04 |