| NPI | 1508560962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A200666) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.081545) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2025-03-25 |