NPI | 1477649036 |
---|---|
Former Name | CARMEN KIMBERLY BAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: OR MD187023) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD 60076645) |
208600000X Surgery (Licence: TX T4936) | |
208600000X Surgery (Licence: ID M14637) | |
208600000X Surgery (Licence: UT 11250182-1205) | |
Enumeration Date | 2006-10-04 |
Last Update Date | 2025-09-25 |