| NPI | 1821581034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2024028363) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11315) |
| 207Q00000X Family Medicine (Licence: IL 036157039) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-07-16 |