| NPI | 1790181808 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 247200000X Technician, Other (Licence: TX 3029) | 
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | 
| Enumeration Date | 2014-11-17 | 
| Last Update Date | 2018-04-23 |