| NPI | 1720514672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 67090) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125070190) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-07-24 |