| NPI | 1235340753 |
|---|---|
| Former Name | AMY ANN TLUSTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 47120-020) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 47120-020) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2008-09-04 |