| NPI | 1639480759 |
|---|---|
| Former Name | CARLIE REBECCA KENNEDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: CA A127831) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 127831) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2019-12-27 |