| NPI | 1902184708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S7482) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.133826) |
| 207Q00000X Family Medicine (Licence: IL 125.060356) | |
| 207Q00000X Family Medicine (Licence: MA 272981) | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2021-01-05 |