| NPI | 1255851218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.152845) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071215) |
| 208000000X Pediatrics (Licence: IL 125.071215) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2023-06-01 |