| NPI | 1649619941 |
|---|---|
| Former Name | AMANDA RAE DORALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A181980) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: CA A181980) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-04-28 |