NPI | 1922354380 |
---|---|
Former Name | ELIZABETH ANNE VILLEGAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017490) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 125109) |
Enumeration Date | 2012-08-02 |
Last Update Date | 2016-09-30 |