| NPI | 1821007626 |
|---|---|
| Former Name | MICHELE L. CANAMUCIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2003-00228) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 2003-00228) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2013-03-21 |