| NPI | 1629077110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO 29322) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036056844) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2010-02-21 |