| NPI | 1790978955 |
|---|---|
| Former Name | ANNA SMIRNOV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 250561) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB10058000) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2020-06-19 |