| NPI | 1437316106 |
|---|---|
| Former Name | OLIVIA MARIE GRANILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 48469) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 48469) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-08-09 |