NPI | 1679632251 |
---|---|
Former Name | PAULA MELISSA JACOB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 076629) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A85176) |
Enumeration Date | 2006-12-08 |
Last Update Date | 2022-03-01 |