| NPI | 1528293677 |
|---|---|
| Former Name | LEAH MONIQUE FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A77191) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A77191) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2024-04-27 |