| NPI | 1033615414 |
|---|---|
| Former Name | YEISEL ALFONSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME152142) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 239050) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2021-10-15 |