| NPI | 1710279104 |
|---|---|
| Other Name | CARL LAMAR FULLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN167051) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 817553) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2013-06-05 |