| NPI | 1962627984 |
|---|---|
| Former Name | MARCENE RENEE MCVAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX P3650) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX P3650) |
| 208600000X Surgery (Licence: AR E-4933) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OK 42264) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: AR E-4933) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2024-10-18 |