| NPI | 1932442894 |
|---|---|
| Other Name | MARISSA BLANCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 51601) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2018-08-28 |