| NPI | 1942563754 |
|---|---|
| Former Name | ANNA O ELEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61274361) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A127061) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-07-21 |