| NPI | 1487403697 |
|---|---|
| Former Name | ANDREA LANAE SPARKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR 226720) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR 220411) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2025-08-20 |