| NPI | 1962817890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 125066226) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL TRN29844) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2021-09-24 |