| NPI | 1003378357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023030140) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A177985) |
| 207Q00000X Family Medicine (Licence: IL 125-XXXXXx) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2024-01-30 |