NPI | 1245434802 |
---|---|
Former Name | ANGELA RACQUEL GARDNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N3660) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP1-0024638) |
Enumeration Date | 2007-06-14 |
Last Update Date | 2022-02-01 |