| NPI | 1104211929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: IN 01029943A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WV 11657) |
| 208D00000X General Practice (Licence: CA C40856) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |