| NPI | 1952303489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R2815) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301076775) |
| 207Q00000X Family Medicine (Licence: IL 036117361) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2018-06-29 |