| NPI | 1912267147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125-061857) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q9476) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2016-09-20 |