| NPI | 1265968655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 74035) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.070653) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2023-10-15 |