NPI | 1861704181 |
---|---|
Former Name | IRIDA HASALLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 56841) |
Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: KY 48240) |
207R00000X Internal Medicine (Licence: KY 48240) | |
Enumeration Date | 2010-07-02 |
Last Update Date | 2018-04-06 |