| NPI | 1760618243 |
|---|---|
| Former Name | IRMANIE ELIACIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME108465) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 13485) |
| 207Q00000X Family Medicine (Licence: NC 2015-02115) | |
| 207Q00000X Family Medicine (Licence: SC MD51757) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2019-02-20 |