| NPI | 1487753596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 35977-020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036085335) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-05-25 |