| NPI | 1235932195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125.085942) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 101410-851) |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-07-03 |