| NPI | 1538512280 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.148803) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125068575) | 
| Enumeration Date | 2016-07-18 | 
| Last Update Date | 2020-06-03 |