Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist | MA41225 | FL |
NPI | 1275819005 |
---|---|
Provider Name | Mrs. Aneta Graca |
First Address | Tampa, FL 33622-2807 |
Second Address | Tampa, FL 33629-7211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2011 |
Last Update Date | 25/10/2011 |