| NPI | 1508188111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036134095) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 243290) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2016-11-08 |