| NPI | 1235126632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 35825020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-092051) |
| 207Q00000X Family Medicine (Licence: MI 4301082097) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2017-04-13 |