NPI | 1992044846 |
---|---|
Former Name | KELLY BETH SAMARTINO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 67122-21) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS018162) |
Enumeration Date | 2013-02-12 |
Last Update Date | 2021-12-28 |