NPI | 1922368810 |
---|---|
Former Name | MEGAN FRITTON GARDNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CT 56049) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2086S0129X Surgery, Vascular Surgery (Licence: RI MD16473) | |
Enumeration Date | 2012-05-24 |
Last Update Date | 2023-05-01 |