| NPI | 1710083670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2000146107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-099978) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2016-12-09 |