| NPI | 1598173403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 10869093-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125065213) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2020-07-21 |