NPI | 1588720601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 64606) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-116805) |
Enumeration Date | 2007-01-01 |
Last Update Date | 2015-01-15 |