| NPI | 1811978059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME152269) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036081949) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2022-09-08 |