| NPI | 1073620175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-110347) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 5538) |
| 207Q00000X Family Medicine (Licence: WI 47901) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2018-10-22 |