NPI | 1093992679 |
---|---|
Former Name | MARISSA DECASTRO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2011013954) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 002828) |
Enumeration Date | 2008-01-26 |
Last Update Date | 2011-12-29 |