| NPI | 1043638406 |
|---|---|
| Former Name | KRYSTAL LYNN CARLOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 18758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.129612) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2019-08-22 |