| NPI | 1861788648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 054845) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125060231) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2019-08-02 |