NPI | 1114224391 |
---|---|
Former Name | VICTORIA LYN MOSCARDELLI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: IL 036139890) |
Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TN 5942) |
Enumeration Date | 2011-02-23 |
Last Update Date | 2025-05-15 |