NPI | 1114083466 |
---|---|
Former Name | ELISSA SCHLICHTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2013-01436) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A7368) |
207Q00000X Family Medicine (Licence: NY 212592) | |
Enumeration Date | 2006-12-29 |
Last Update Date | 2017-03-17 |