| NPI | 1639522063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME165302) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.149705) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2024-06-03 |