| NPI | 1124453626 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS12965) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS12965) | 
| 207R00000X Internal Medicine (Licence: FL UO3569) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ML0512965) | |
| Enumeration Date | 2013-09-04 | 
| Last Update Date | 2025-04-01 |