| NPI | 1871779744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-117196) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: IL 036117196) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2026-05-14 |