| NPI | 1275979965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A144496) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.062901) |
| 207Q00000X Family Medicine (Licence: IL 036.141180) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2018-03-17 |