| NPI | 1902154149 |
|---|---|
| Former Name | AMBER WAITS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID M-13005) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A122460) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2022-07-21 |