| NPI | 1710122429 |
|---|---|
| Former Name | LYNN MARIE GRANSEWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 2017-01139) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 5425) |
| 207R00000X Internal Medicine (Licence: GA 005425) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2018-11-20 |