NPI | 1538553490 |
---|---|
Former Name | ALYSSA M SHELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 289471) |
Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 289471) |
Enumeration Date | 2015-03-27 |
Last Update Date | 2023-06-09 |