NPI | 1295197879 |
---|---|
Former Name | ELISSA CRISTINA PRADO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX S2785) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-03-23 |
Last Update Date | 2020-08-05 |