| NPI | 1316202278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124508) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125061664) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2018-12-17 |