| NPI | 1225392616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C167734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-062306) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2022-06-14 |