NPI | 1962417717 |
---|---|
Former Name | KATHERINE GRACE MENK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NC 2017-02317) |
Additional Taxonomies | 208600000X Surgery (Licence: VA 0101241803) |
Enumeration Date | 2006-07-30 |
Last Update Date | 2021-04-02 |