| NPI | 1790215747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125.071133) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 32578) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-07-21 |