| NPI | 1972862142 |
|---|---|
| Former Name | RACHEL FOSDAHL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2023050214) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: SC MD52272) |
| 208600000X Surgery (Licence: TX R3297) | |
| 208600000X Surgery (Licence: SC 52272) | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2026-07-15 |