NPI | 1376109777 |
---|---|
Former Name | ALEXIS ANNE BLIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME176085) |
Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: NJ 25MA12296700) |
Enumeration Date | 2019-05-13 |
Last Update Date | 2025-09-03 |