| NPI | 1487340469 |
|---|---|
| Former Name | CARMEN GILMARY TELLES CHACON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 86201) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 86201) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2026-01-12 |