| NPI | 1073565065 |
|---|---|
| Former Name | ALICE A. GRICOWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35-05-3018) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 15255) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2021-01-21 |