| NPI | 1104182963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T7988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.125239) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2022-11-23 |