| NPI | 1023305216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101026241) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.059226) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2021-09-15 |