NPI | 1356312359 |
---|---|
Former Name | AMY ELIZABETH RADICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX R0412) |
Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: VA 0102201628) |
207X00000X Orthopaedic Surgery (Licence: VA 0102201628) | |
Enumeration Date | 2006-01-28 |
Last Update Date | 2017-10-24 |