| NPI | 1043412893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-123950) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125-053128) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2021-04-28 |