| NPI | 1801367776 |
|---|---|
| Former Name | DOLORES PENA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: NY 18-512) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |