| NPI | 1780143263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: 187422) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 187422) |
| 363AS0400X Physician Assistant, Surgical (Licence: 187422) | |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2023-09-19 |