| NPI | 1265400717 |
|---|---|
| Former Name | AUDREY G BOLANOWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL 145718) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 166726) |
| 208600000X Surgery (Licence: CO 0053119) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2026-06-22 |