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 |