| NPI | 1528104650 |
|---|---|
| Former Name | THERESA L ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A110524) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: NE 24637) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2012-09-05 |