NPI | 1841752250 |
---|---|
Former Name | JULISSA PLACENCIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 338497) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036161456) |
Enumeration Date | 2019-04-03 |
Last Update Date | 2023-09-12 |