| NPI | 1689839177 |
|---|---|
| Former Name | IDA JANELLE DUGGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA11470600) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD434346) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2022-08-24 |