| NPI | 1184039422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R3959) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.064639) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2022-07-21 |