| NPI | 1982800876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036126335) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57009749) |
| 207Q00000X Family Medicine (Licence: IA 38092) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2013-06-28 |