NPI | 1487877551 |
---|---|
Former Name | BONNIE HEATHER SCIAMBRA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 28202) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0078684) |
207Q00000X Family Medicine (Licence: AK 6796) | |
Enumeration Date | 2007-04-10 |
Last Update Date | 2023-07-03 |