NPI | 1003208083 |
---|---|
Former Name | LISSETTE PEREZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS15013) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-02-26 |
Last Update Date | 2023-08-22 |