NPI | 1477696193 |
---|---|
Former Name | SVETLANA CLARAVALL LAZARO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 268281) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 24607) |
Enumeration Date | 2007-02-14 |
Last Update Date | 2020-11-18 |