| NPI | 1518192467 |
|---|---|
| Former Name | JOZIA COLEEN LUTACKAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO MO2012035077) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101018158) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2013-01-02 |