| NPI | 1760570626 |
|---|---|
| Former Name | SHARLA GAYLE WARTES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME115033) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 062152) |
| 208600000X Surgery (Licence: AL 27211) | |
| 208600000X Surgery (Licence: MS 21116) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-12-02 |