NPI | 1063547867 |
---|---|
Former Name | RHODALINE REBANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C160215) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101241117) |
Enumeration Date | 2007-02-22 |
Last Update Date | 2019-07-16 |