NPI | 1699260620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 12448138-1205) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.072499) |
Enumeration Date | 2018-06-22 |
Last Update Date | 2021-12-10 |