NPI | 1104321272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036157305) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207Q00000X Family Medicine (Licence: IL 125.071794) | |
Enumeration Date | 2018-03-29 |
Last Update Date | 2023-06-26 |