| NPI | 1548780844 |
|---|---|
| Former Name | MANDALYN J KAUTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2022016390) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101023019) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-09-15 |