| NPI | 1699700658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60424466) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036114371) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-11-15 |