| NPI | 1639759293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.174387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2024037525) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2025-09-30 |