| NPI | 1982688735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 10903589-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036111670) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2020-12-23 |