| NPI | 1336464544 |
|---|---|
| Former Name | AMANDA CELEST ROOF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: WA MD60482537) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 43587) |
| 207X00000X Orthopaedic Surgery (Licence: WI 65700) | |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60482537) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2019-02-27 |