| NPI | 1306294129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301500379) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.068695) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2019-08-05 |