| NPI | 1912436841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 2020-00884) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125070318) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2021-09-08 |