NPI | 1417136276 |
---|---|
Former Name | ALYSSA FLANAGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0076411) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.123141) |
208000000X Pediatrics (Licence: IL 036.123141) | |
208000000X Pediatrics (Licence: MD D0076411) | |
Enumeration Date | 2007-10-29 |
Last Update Date | 2017-03-20 |