| NPI | 1790392736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: CO ANT.0000185) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: WI 171) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2022-08-22 |