| NPI | 1447512199 |
|---|---|
| Former Name | DESIRAE NASRALLAH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS15979) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0536749) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2019-09-13 |