| NPI | 1407219124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125-074854) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 208600000X) |
| 208D00000X General Practice (Licence: MO 2018016173) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2023-10-02 |