| NPI | 1760778591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 74160) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036133609) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.059083) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2019-02-07 |