NPI | 1609178839 |
---|---|
Former Name | CIRA PATRICIA BALLESTAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME118826) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2010-11-19 |
Last Update Date | 2021-09-09 |