| NPI | 1285920728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102203276) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102203276) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: VA 0102203276) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2024-04-05 |