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Individual
MARY KRISTINE CARBULLIDO
Active
Individual
MARY KRISTINE CARBULLIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
FC2728511
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/12/2021
Last updated
06/12/2023
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