| NPI | 1821595877 |
|---|---|
| Former Name | DIVA VITEARE BOMGAARS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-48710) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 33607) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2026-04-12 |