NPI | 1538819529 |
---|---|
Former Name | MONICA MARION MAZUR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: FL ME165113) |
Additional Taxonomies | 208600000X Surgery (Licence: FL TRN35080) |
Enumeration Date | 2022-03-24 |
Last Update Date | 2024-10-09 |