| NPI | 1982808523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-115821) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47294-021) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2007-07-08 |