| NPI | 1750497459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S2168) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-098719) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-07-02 |