| NPI | 1386819928 |
|---|---|
| Former Name | AHGNES UNGOCO BOLUSA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243921) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 266535) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2024-05-13 |