NPI | 1639495708 |
---|---|
Former Name | KRYSTEN MARIE BOTIMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: ID M-13270) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 74281) |
207X00000X Orthopaedic Surgery (Licence: CA A118962) | |
Enumeration Date | 2010-04-14 |
Last Update Date | 2017-01-10 |