| NPI | 1790103158 |
|---|---|
| Former Name | ANGELA MONIQUE MAYORGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D85038) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D85038) |
| 207R00000X Internal Medicine (Licence: WI 76847-20) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2023-06-27 |