| NPI | 1346863875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 82460) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125076652) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2023-10-12 |