NPI | 1932786555 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 1024763) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 13937238-1205) |
207Q00000X Family Medicine (Licence: IL 125078604) | |
Enumeration Date | 2021-03-28 |
Last Update Date | 2025-09-03 |