| NPI | 1659803997 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036153995)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A159158)  | 
| Enumeration Date | 2017-03-28 | 
| Last Update Date | 2021-08-09 |