| NPI | 1922624832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 323901) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.077117) |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2024-03-27 |