| NPI | 1871814509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: CT 0044440) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 074163) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2010-10-11 |