NPI | 1780061150 |
---|---|
Former Name | SELINA S PATEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 147437) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 287455) |
207Q00000X Family Medicine (Licence: CT 56047) | |
207Q00000X Family Medicine (Licence: MI 4301110938) | |
Enumeration Date | 2015-05-05 |
Last Update Date | 2019-05-16 |