| NPI | 1700887338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60114770) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 36096988) |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2010-09-22 |