| NPI | 1114993896 |
|---|---|
| Former Name | IDA MARY S-M-LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101058066) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: VA 011058066) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-07-08 |