| NPI | 1235229568 |
|---|---|
| Former Name | MARY ALICE PARISH GAVINSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 26129) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2015-11-23 |