NPI | 1639148703 |
---|---|
Former Name | MICHELLE DIANA ELMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MD D85603) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301109336) |
208600000X Surgery (Licence: FL ME93526) | |
Enumeration Date | 2006-03-14 |
Last Update Date | 2019-09-16 |