| NPI | 1952782518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R9900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036144546) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2020-04-28 |