| NPI | 1649899899 |
|---|---|
| Former Name | CATHERINE ANNE MANGUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME160073) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN31299) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-09-26 |