NPI | 1003012410 |
---|---|
Former Name | LORELANE PAGULAYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA08833500) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 048737) |
207Q00000X Family Medicine (Licence: NJ 25MA0883500) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-06-22 |
Last Update Date | 2022-09-14 |