NPI | 1508152554 |
---|---|
Former Name | LINDSEY ANN DIERLAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: IN 02005082A) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 5101019350) |
Enumeration Date | 2011-06-28 |
Last Update Date | 2022-07-21 |