| NPI | 1962713073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.133055) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2010019726) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2014-10-08 |