| NPI | 1871120030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 315218) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036178121) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-03-02 |