NPI | 1639304389 |
---|---|
Former Name | RENATO YAMBAO BERNARDO |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C168638) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME112631) |
Enumeration Date | 2009-05-26 |
Last Update Date | 2022-02-11 |