| NPI | 1841624491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: IL 238.000370) |
| Additional Taxonomies | 171W00000X Contractor (Licence: IL 238.000370) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2020-11-18 |