| NPI | 1629204961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: IL 036128700) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125055971) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2018-05-31 |