| NPI | 1437404431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 48150) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-061897) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2018-09-06 |