| NPI | 1750768685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036144531) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125067774) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2019-04-04 |