| NPI | 1023454717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 62115) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.062951) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2022-07-21 |