NPI | 1104001791 |
---|---|
Former Name | MANDY JO VIRANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ 25MA08889300) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD447260) |
207T00000X Neurological Surgery (Licence: CO DR.0072396) | |
Enumeration Date | 2008-01-02 |
Last Update Date | 2024-05-14 |