NPI | 1154371292 |
---|---|
Former Name | MARIA THERESA SAN AGUSTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA C51083) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 205725-1) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2007-07-08 |