| NPI | 1740529825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: 12-0802) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: LA ATH.200348) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2014-07-16 |