| NPI | 1356978654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.165943) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.076818) |
| 207Q00000X Family Medicine (Licence: WI 82257-20) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2023-11-07 |