| NPI | 1154687077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2018020904) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036140361) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2020-03-31 |