| NPI | 1104321348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22144) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 14673I) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2021-07-27 |