| NPI | 1790001568 |
|---|---|
| Former Name | YAVARACE VONGSIVAVILAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 18482) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: KY 18482) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2010-04-19 |