| NPI | 1275050429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.153929) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.080075) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2025-06-17 |