| NPI | 1124384789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-01815) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036138106) |
| 207Q00000X Family Medicine (Licence: IL 125061830) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2022-10-03 |