| NPI | 1679524672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IA MD-36386) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036124952) |
| 207Q00000X Family Medicine (Licence: WI 63999-20) | |
| Enumeration Date | 2006-05-14 |
| Last Update Date | 2024-01-03 |