| NPI | 1679630297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 52462) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.122393) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-04-16 |