| NPI | 1811418627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T4876) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125070400) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2025-12-06 |