Individual
VANESSA MITSIALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
279791
MA
207RG0100X
Gastroenterology Physician
Primary
279791
MA
Other
Enumeration date
06/05/2013
Last updated
09/05/2019
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