| NPI | 1811288400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301108583) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.134077) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2020-01-07 |