| NPI | 1922017664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 32418) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-058644) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-11-23 |