| NPI | 1568921435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 80046-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.073787) |
| 207Q00000X Family Medicine (Licence: IL 125073787) | |
| 208D00000X General Practice (Licence: IL 125.073787) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-09-19 |