NPI | 1447244793 |
---|---|
Former Name | JAN AQUILINO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS 8854) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB11729700) |
207Q00000X Family Medicine (Licence: NY 222891) | |
Enumeration Date | 2005-09-01 |
Last Update Date | 2023-02-21 |