| NPI | 1255320578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.125173) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301076196) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2012-11-13 |