| NPI | 1962062141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS19286) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.074369) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2024-03-01 |