| NPI | 1720288236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2010024506) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-052442) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2012-03-07 |