| NPI | 1326452921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 71089-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 05775) |
| 207Q00000X Family Medicine (Licence: IL 036.144957) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2024-06-06 |