| NPI | 1558365130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N0635) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 13603R) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2014-10-06 |