| NPI | 1740930585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102209334) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.080288) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2025-09-08 |