| NPI | 1750648671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 61396) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.136109) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2021-03-11 |