| NPI | 1184730921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM A-1889-15) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-096178) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2015-10-28 |