| NPI | 1558682864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60672297) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036132409) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2020-12-08 |