| NPI | 1558394759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P9736) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 0420010015) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2021-04-16 |