| NPI | 1386737674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 31236020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-080979) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2026-06-18 |