NPI | 1255569661 |
---|---|
Former Name | LISA MARIE CHARGUALAF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T2138) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A150055) |
Enumeration Date | 2009-06-24 |
Last Update Date | 2021-07-29 |