| NPI | 1831639749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: TX SA00892) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2022-07-07 |