| NPI | 1891862678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 38253) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-097672) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2023-12-04 |