NPI | 1144586405 |
---|---|
Former Name | CARLA CARLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 63237) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 63237) |
208M00000X Hospitalist (Licence: FL ME147928) | |
Enumeration Date | 2012-04-11 |
Last Update Date | 2023-06-30 |