| NPI | 1700014651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2019025540) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036141286) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2021-02-11 |