NPI | 1194060061 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036137180) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125062506) |
207Q00000X Family Medicine (Licence: TX Q6294) | |
Enumeration Date | 2012-12-04 |
Last Update Date | 2016-03-29 |