| NPI | 1881221497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 341673) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.075429) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2026-02-09 |