| NPI | 1104388065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 90637) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125075043) |
| 207Q00000X Family Medicine (Licence: IL 036.160037) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2023-08-22 |