| NPI | 1811377617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036147122) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 68350) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2025-12-04 |