| NPI | 1366450520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2016016020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 03607617) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2019-12-09 |