| NPI | 1467713776 |
|---|---|
| Former Name | CARLA FORTIQUE GOMEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 155003) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX S4139) |
| 208M00000X Hospitalist (Licence: MA 263147) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2024-10-31 |