| NPI | 1265952717 |
|---|---|
| Former Name | MICHELLE JOY FUENTES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10872400) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2020-09-02 |