| NPI | 1578945861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R5115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT209823) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2018-08-16 |