| NPI | 1215917141 |
|---|---|
| Former Name | CAROL VICTORIA TIEVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 9812) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AL 9812) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2012-10-01 |