| NPI | 1912228644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: TX 3519) |
| Additional Taxonomies | 171W00000X Contractor (Licence: TX 3519) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2013-11-07 |