NPI | 1639435266 |
---|---|
Former Name | ELIZABETH MIRDZA SPERO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 70495) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX Q8796) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-09 |
Last Update Date | 2023-07-31 |