| NPI | 1003127366 |
|---|---|
| Former Name | VIVIAN ALICE JOLLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 300153-01) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q9291) |
| 208600000X Surgery (Licence: SC LL32911) | |
| 208600000X Surgery (Licence: NJ 25MA10160900) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2019-09-11 |