| NPI | 1982899795 |
|---|---|
| Former Name | HEIDI CORYELL AMBROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MT 49525) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD00048758) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2021-03-09 |