NPI | 1659370161 |
---|---|
Former Name | CHRISTA ANN RUBLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: KS 04-31985) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2006018662) |
Enumeration Date | 2005-07-18 |
Last Update Date | 2014-11-25 |