| NPI | 1063822575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO192778) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 72086) |
| 207Q00000X Family Medicine (Licence: IL 036.144140) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2023-09-15 |