| NPI | 1093102287 |
|---|---|
| Former Name | JACQUELYN NICOL CARLSSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60870345) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60870345) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2021-04-28 |