NPI | 1457335630 |
---|---|
Former Name | MARICELINA CARO KNOTTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200201346) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL ME141143) |
Enumeration Date | 2005-12-01 |
Last Update Date | 2020-02-21 |