NPI | 1588196836 |
---|---|
Former Name | CRYSTAL MARELLI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U5426) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 320101) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-28 |
Last Update Date | 2023-10-16 |