| NPI | 1023404803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX S554) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207R00000X Internal Medicine (Licence: VA 0101262390) | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2024-04-19 |