| NPI | 1790104131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R4830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 51372) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2025-03-05 |