| NPI | 1750401253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2013009618) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.120199) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-11-19 |