| NPI | 1295145167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: IL 036.157906) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS13475) |
| 207Q00000X Family Medicine (Licence: IL 036157906) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2025-05-21 |