| NPI | 1144482480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.133885) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 5928) |
| 207Q00000X Family Medicine (Licence: WI 55897) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2014-04-15 |