NPI | 1932370335 |
---|---|
Former Name | CAMILLE AVINA RILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA MD60012912) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A90872) |
Enumeration Date | 2008-03-13 |
Last Update Date | 2020-11-23 |