| NPI | 1861922205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: FL MW409) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: FL 14-482) |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2022-07-21 |