| NPI | 1699791400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036112086) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-49275) |
| 207Q00000X Family Medicine (Licence: KY C0517) | |
| 207Q00000X Family Medicine (Licence: MI EMC0001491) | |
| 207Q00000X Family Medicine (Licence: MN 70538) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2021-12-07 |