| NPI | 1104847458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q7205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-047892) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-03-09 |