| NPI | 1326123563 |
|---|---|
| Former Name | IVO TZVETANOV IATCHOVSKI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.201181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME96106) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-05-29 |