| NPI | 1235115619 |
|---|---|
| Former Name | PAULA ELIZABETH ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 2666) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34007682) |
| 208600000X Surgery (Licence: TN DO0000001955) | |
| 208600000X Surgery (Licence: AK 6118) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2012-08-07 |