NPI | 1679074132 |
---|---|
Former Name | CASSANDRA LEE CZARNETZKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OK 6637) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 6637) |
Enumeration Date | 2018-02-21 |
Last Update Date | 2023-12-19 |