NPI | 1942569231 |
---|---|
Former Name | MACKENZIE LEE BEAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: UT 11768709-1205) |
Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35136866) |
Enumeration Date | 2012-05-08 |
Last Update Date | 2023-07-05 |