NPI | 1497717078 |
---|---|
Former Name | KRISTINA N VANDENBOSCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 202K00000X Phlebology (Licence: NM MD2014-0808) |
Additional Taxonomies | 202K00000X Phlebology (Licence: CO 43226) |
202K00000X Phlebology (Licence: TX P9455) | |
Enumeration Date | 2006-04-06 |
Last Update Date | 2022-07-28 |