NPI | 1962553578 |
---|---|
Former Name | VALERIE J CORDERO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 7876A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00043851) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2008-09-30 |