NPI | 1871975128 |
---|---|
Former Name | CRISTA DANAE NAZARIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 36310) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 11182) |
Enumeration Date | 2015-06-23 |
Last Update Date | 2024-11-04 |