NPI | 1609015577 |
---|---|
Former Name | REBECCA JUDENE GARNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: IA 38581) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 248293-1) |
Enumeration Date | 2009-02-17 |
Last Update Date | 2021-10-13 |