| NPI | 1710481510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX S5901) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125072223) |
| 207R00000X Internal Medicine (Licence: TX S5901) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2022-11-14 |