NPI | 1639607567 |
---|---|
Former Name | TOME TAMATY ELYAGUOV |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB11018800) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 303324-01) |
Enumeration Date | 2017-05-23 |
Last Update Date | 2024-10-02 |