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 |