| NPI | 1104124221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036177585) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.096519) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2026-08-10 |