| NPI | 1215185715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-128171) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 56124) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125054359) | |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2020-12-16 |