| NPI | 1679926752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 71501) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125069690) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2022-09-13 |