| NPI | 1972731958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME128743) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-056928) |
| 207Q00000X Family Medicine (Licence: IL 036.129497) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2018-09-28 |