| NPI | 1780065730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R5921) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-067138) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2023-10-25 |