| NPI | 1063772440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NE 1559) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO DR.0075811) |
| 208D00000X General Practice (Licence: TX Q2075) | |
| Enumeration Date | 2012-05-20 |
| Last Update Date | 2025-09-20 |