| NPI | 1982165452 |
|---|---|
| Former Name | RACHEL LOUCRETIA MANTYLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.154341) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036159331) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-09-24 |