| NPI | 1467584979 |
|---|---|
| Former Name | CARRIE LEE JOHNSON WALLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A93710) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A93710) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: CA A93710) | |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2020-01-02 |