NPI | 1750700431 |
---|---|
Former Name | VANESSA MICHELLE MALLOL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R8836) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 40683) |
Enumeration Date | 2014-04-10 |
Last Update Date | 2023-05-23 |