| NPI | 1710140744 |
|---|---|
| Former Name | ELIZABETH ANN VAN IPEREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME126141) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 238165) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2016-11-15 |