| NPI | 1700267465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A163089) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A163089) |
| 207R00000X Internal Medicine (Licence: IL 125-067672) | |
| 208000000X Pediatrics (Licence: CA A163089) | |
| 208000000X Pediatrics (Licence: IL 125-067672) | |
| 208D00000X General Practice (Licence: IL 125-067672) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2023-04-02 |