NPI | 1689980294 |
---|---|
Former Name | JOHANNA PATRICIA SERRANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD452562) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 287419) |
282N00000X General Acute Care Hospital (Licence: PA MD452562) | |
Enumeration Date | 2010-08-20 |
Last Update Date | 2021-01-18 |