| NPI | 1235799560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 338345) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.075050) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-04-12 |