NPI | 1922433200 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: GA 144655) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX 14-4655) |
Enumeration Date | 2013-09-05 |
Last Update Date | 2025-08-21 |