| NPI | 1346890704 |
|---|---|
| Former Name | MORAIMA IRENE BATISTA CARMONA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1212) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21560) |
| 246RH0600X Technician, Pathology, Histology (Licence: FL TN42695) | |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2020-06-14 |