| NPI | 1184641987 |
|---|---|
| Former Name | JOHANNA C FUENTES-DAZA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C137378) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 8471315-1205) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2017-05-02 |