| NPI | 1639564057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 274859) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125066819) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2018-09-18 |