NPI | 1184866675 |
---|---|
Former Name | IRMA MARIANA SANTIAGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-00102) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2012-0350) |
Enumeration Date | 2009-03-30 |
Last Update Date | 2021-10-01 |