NPI | 1295120947 |
---|---|
Former Name | SHANNON KATINA SERLEMITSOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101281100) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D87560) |
Enumeration Date | 2015-03-31 |
Last Update Date | 2024-06-03 |