| NPI | 1790070258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125059740) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 146409) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2019-09-30 |