| NPI | 1225265994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60274328) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125057053) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2024-07-09 |