| NPI | 1902268634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 65360) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.069369) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-07-04 |