| NPI | 1114174497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P0443) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125055517) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2022-09-01 |