| NPI | 1710697909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101287107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125081100) |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2026-07-23 |