NPI | 1629311840 |
---|---|
Former Name | MICHELLE SUSAN GRUZMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A13754) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-04-05 |
Last Update Date | 2016-09-28 |