NPI | 1770141277 |
---|---|
Former Name | NANCY ANASTASIA BOBRYSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB11440100) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT019057) |
207Q00000X Family Medicine (Licence: NY 316804-01) | |
Enumeration Date | 2019-05-31 |
Last Update Date | 2022-10-07 |