| NPI | 1972731115 |
|---|---|
| Former Name | MALLORY ANNE BALMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 278446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P1446) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2022-10-05 |