NPI | 1225452956 |
---|---|
Former Name | KATE MARIE CLENDENEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 34.014126) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MI 5101026372) |
Enumeration Date | 2014-02-17 |
Last Update Date | 2025-01-21 |