| NPI | 1578977963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX T9079) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2016034277) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2022-09-29 |