| NPI | 1720565336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 234893) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-073-419) |
| 207Q00000X Family Medicine (Licence: IL 036.159226) | |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2025-09-10 |