| NPI | 1801418975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 346206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125076325) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2025-05-27 |