NPI | 1235581034 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D90743) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.068669) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2021-10-13 |