| NPI | 1174902472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036.145406) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125066448) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2022-09-19 |