NPI | 1710445861 |
---|---|
Former Name | JESSICA ELEN ESTRADA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 010271469) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 010271469) |
208D00000X General Practice (Licence: VA 1710445861) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-07 |
Last Update Date | 2024-05-29 |