NPI | 1801275797 |
---|---|
Former Name | ANDREA ANTONIETA MORENO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME145759) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-05-25 |
Last Update Date | 2022-03-29 |