| NPI | 1063510659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-115308) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00042710) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-11-18 |