| NPI | 1114411956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 75853-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036153728) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2021-09-01 |