| NPI | 1952705733 |
|---|---|
| Former Name | MISTY M MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: KY 132002) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |