| NPI | 1225423031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301116381) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.067639) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2019-06-03 |