| NPI | 1942837653 |
|---|---|
| Former Name | MARY AGNES PAVLOVICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 335849-01) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-07-21 |