| NPI | 1780321000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301514754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.079287) |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2025-07-22 |