| NPI | 1104824085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 29964) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036068363) |
| 207P00000X Emergency Medicine (Licence: WI 29964) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2019-09-12 |