| NPI | 1912474156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL PA9111629) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9111629) |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2020-04-06 |