| NPI | 1497721450 |
|---|---|
| Former Name | TATYANA POLOVENKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 002312) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 002312) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2021-06-11 |