| NPI | 1942436571 |
|---|---|
| Former Name | TINAROSE MARY BOSSLET |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2012028151) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2009014344) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2014-01-22 |