| NPI | 1487096459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 54895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-063338) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2022-12-13 |