| NPI | 1871346726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125.083845) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 90200000x) |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-07-16 |