| NPI | 1710545405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2022037015) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125074342) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2024-02-15 |