| NPI | 1730521881 |
|---|---|
| Former Name | GABRIELLA NICOLE BLANCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 144862) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 30056) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2021-03-08 |