| NPI | 1356784383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 296332) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.062787) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2019-01-14 |