| NPI | 1801316195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 323784) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.070574) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-01-19 |