| NPI | 1538556386 |
|---|---|
| Former Name | JADE KRISTIN PALAZZOLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 04653) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 3829) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2022-04-06 |