NPI | 1366889792 |
---|---|
Former Name | MANDI KLEIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0070813) |
Additional Taxonomies | 208600000X Surgery (Licence: CA 163079) |
208600000X Surgery (Licence: NC 2018-00880) | |
Enumeration Date | 2013-05-24 |
Last Update Date | 2023-08-10 |