| NPI | 1902992076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME116400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036110518) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2016-06-21 |