| NPI | 1275162190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 77059) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.164893) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2024-08-01 |