NPI | 1730382854 |
---|---|
Former Name | DEBORAH JANINE MISSAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD037735) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 263043) |
207Q00000X Family Medicine (Licence: MA 231561) | |
Enumeration Date | 2007-06-06 |
Last Update Date | 2012-05-17 |