| NPI | 1679849111 | 
|---|---|
| Former Name | JESSIKA DIAZ LARA | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 70495)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A135774)  | 
| Enumeration Date | 2012-03-29 | 
| Last Update Date | 2019-06-07 |