| NPI | 1467866418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-02377) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-141827) |
| 207Q00000X Family Medicine (Licence: WI 81620-21) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2025-03-13 |