| NPI | 1578581328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2005-01584) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 84113) |
| 207Q00000X Family Medicine (Licence: IL 036.171922) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-04-03 |