| NPI | 1922560812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61251789) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.074784) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-08-02 |