| NPI | 1811132244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009039320) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125051759) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2014-10-02 |