NPI | 1609305846 |
---|---|
Former Name | MARY HERMIZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301502823) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301113060) |
Enumeration Date | 2017-06-10 |
Last Update Date | 2021-01-13 |