| NPI | 1104930353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME105007) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036099039) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2026-07-07 |