| NPI | 1932587797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036153206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 292795) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2020-11-02 |