| NPI | 1457663320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125.058876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 15347-320) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2026-08-14 |