NPI | 1508953043 |
---|---|
Former Name | NONNA O TERESHONOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60011530) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008403) |
Enumeration Date | 2006-10-06 |
Last Update Date | 2023-03-07 |