| NPI | 1558688465 |
|---|---|
| Former Name | CHARLENE ANN VESTERMARK GIBB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S4314) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102202971) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102202971) | |
| Enumeration Date | 2010-05-02 |
| Last Update Date | 2022-01-20 |