| NPI | 1700272572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60858808) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125067879) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2026-01-20 |