| NPI | 1255747697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60950318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.142005) |
| 207Q00000X Family Medicine (Licence: IL 125064802) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2022-07-21 |