NPI | 1649619941 |
---|---|
Former Name | AMANDA RAE DORALE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.139714) |
Additional Taxonomies | 204F00000X Transplant Surgery (Licence: OH 35.139714) |
Enumeration Date | 2013-06-19 |
Last Update Date | 2025-08-25 |