| NPI | 1679976682 |
|---|---|
| Former Name | IDELKA GRISELLE RODRIGUEZ-ROSARIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 277621) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2017-02-15 |