| NPI | 1225264997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R7807) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125056143) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2019-02-07 |