| NPI | 1609281245 |
|---|---|
| Former Name | BETTINA DENNISE RODRIGUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME141448) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD461313) |
| 207Q00000X Family Medicine (Licence: SC 37209) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2021-03-22 |