| NPI | 1639588163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S3527) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-143790) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2021-06-08 |