NPI | 1912149170 |
---|---|
Former Name | KRISTEN ANN HUDAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WI 54773-20) |
Enumeration Date | 2009-04-01 |
Last Update Date | 2024-02-22 |