| NPI | 1972760817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301096049) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-053484) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2017-08-18 |