| NPI | 1740403609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301501412) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.130135) |
| 207Q00000X Family Medicine (Licence: NH 13463) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-10-19 |