| NPI | 1063668994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 54962-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.124091) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2010-09-24 |