| NPI | 1225383417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R3155) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.130630) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2019-08-02 |