| 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 |