| NPI | 1508050899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35093985) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-118960) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2015-01-17 |