| NPI | 1114173515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P7680) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125051312) |
| 207Q00000X Family Medicine (Licence: OH 35-093516) | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2024-08-19 |