| NPI | 1922264605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-124528) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 036-124528) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125-052839) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2023-08-16 |