| NPI | 1639307689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P2425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT013107) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2014-02-14 |