| NPI | 1922790617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 24-279) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 1663-P.A.) |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2024-05-12 |